The Effectiveness of Cognitive Behavior Therapy on Psychological Stress, Physical Health, and Self-Care Behavior among Diabetes Patients: A Systematic Review

Aims: To evaluate the effects of cognitive behavior therapy among randomized controlled trials on psychological stress, physical health, and self-care behavior among type 1 and type 2 diabetes patients. Information Methods: The preferred reporting items for systematic reviews and analysis statement was used in all review stages. Study selection and study quality were based on Jonna Briggs Institute. Relevant articles search from three databases, namely PubMed, CINAHL, and Google Scholar, was conducted. The search yielded 1143 articles and 19 randomized controlled trials met the inclusion criteria to evaluate the effects of cognitive behavior therapy. Findings: Cognitive behavior therapy significantly ameliorated depressive symptoms, anxiety, diabetes-related stress, glycemic control, quality of life, and self-care behavior such as self-blood glucose monitor, medication adherence, and physical activity. However, heterogeneity in terms of cognitive behavior therapy delivery modes, follow-up duration, various outcomes, and long-term effects are considered when interpreting results. Conclusion: Findings suggest that cognitive behavior therapy can be integrated into diabetes management to achieve diabetes outcomes regarding psychological and physical health as well as self-care behavior.